28th National Clinical Education Symposium Presentation Abstracts

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PP-31 Lithium-Induced Severe Hypothyroidism Presenting with Psychotic Mania in a Patient with Bipolar Disorder: A Case Report - Page 229
Ayşe Köksal

PP-32 Combined Treatment Approach in Health Anxiety-Themed Obsessive Ruminations: A Case Report - Page 230
Süleyman Çankaya, Özden Arısoy

PP-33 Hippocampal Subfield Volume Alterations in Schizophrenia: Relationships with Symptom Severity, Verbal Memory Performance and Oxidative Stress - Page 232
Muhammet Gündüz, Osman Özdel, Yaşar Enli, Ergin Sağtaş

PP-34 Anton Syndrome and Manic Switch: A Case Report - Page 235
Süleyman Çankaya, Onur Koçhan

PP-35 Delusional Infestation (Ekbom Syndrome) Associated with Post-Earthquake Trauma and Social Isolation - Page 236
Ezgi Çankaya İnan

PP-36 Hoarding Behavior in Frontotemporal Dementia Successfully Treated with Brexpiprazole: A Case Report - Page 237
Kardelen Erdoğan, Meryem Gül Teksın Taş, Gulsen Teksin, Özge Şahmelikoğlu Onur

21 APRIL 2026, TUESDAY
PP-30 Anhedonia and Increased Alcohol Consumption Following Tirzepatide Use: A Case Report

PP-30 Anhedonia and Increased Alcohol Consumption Following Tirzepatide Use: A Case Report

Deniz Kaya1, Çağla İyice1, Güneş Devrim Kıcalı1

1. Department of Psychiatry,Muğla Sıtkı Koçman University,Muğla,Türkiye

DOI: 10.5080/61upk.ozt519 Page 227
OBJECTIVE Tirzepatide is a dual glucose-dependent insulinotropic polypeptide (GIP) and glucagon like peptide-1 (GLP-1) receptor agonist. Beyond appetite regulation, GLP-1–based therapies may modulate dopaminergic signaling within the brain’s reward circuitry. While selective GLP-1 receptor agonists primarily suppress appetite, dual GIP/GLP-1 receptor activation may exert broader neurobehavioral effects. We report a case of marked anhedonia temporally associated with tirzepatide use, followed by increased alcohol consumption and psychiatric hospitalization. CASE A 49-year-old male was initiated on tirzepatide in an endocrinology outpatient clinic for weight loss. During treatment, he developed prominent anhedonia, decreased motivation, appetite suppression beyond the expected pharmacological effect, sleep disturbance, and anxiety symptoms. In an attempt at self-medication, he began consuming approximately 7–8 standard alcoholic drinks per day. He subsequently discontinued tirzepatide on his own and presented to the psychiatry outpatient clinic. He denied prior alcohol withdrawal symptoms, alcohol-related functional impairment, psychiatric diagnoses, or family psychiatric history. There was no suicidal ideation. Although he did not meet DSM-5 criteria for Alcohol Use Disorder, he was hospitalized due to worsening depressive symptoms, functional decline, and rapidly escalating alcohol consumption as a maladaptive coping strategy. Mental status examination revealed dysphoric mood, restricted affect, psychomotor retardation, and reduced spontaneous speech without psychotic features. Following detoxification and supportive interventions, sertraline was initiated and titrated to 100 mg/day. Acamprosate 999 mg/day was added to prevent relapse. At discharge, he was euthymic and abstinent from alcohol. Written informed consent was obtained. DISCUSSION Although clinical trials report a low incidence of major psychiatric adverse effects with tirzepatide, this case highlights possible individual vulnerability. Dual GIP/GLP-1 modulation may enhance inhibitory effects on mesolimbic dopaminergic pathways, potentially inducing a clinically significant “reward deficit.” In susceptible individuals, such pharmacologically induced anhedonia may paradoxically promote compensatory alcohol use. Further research is warranted to clarify the neuropsychiatric safety profile of dual incretin agonists Keywords: Alcohol use, Anhedonia, Case report, GLP-1 receptor agonist, Reward system, Tirzepatide